Endotoxins and Biological Implications—Review

ABSTRACT Endotoxins, also known as lipopolysaccharides (LPSs), are structural components of the outer membrane of Gram‐negative bacteria and some cyanobacteria. They are among the most potent pyrogens and remain a persistent challenge in environmental, occupational, and clinical settings. This review brings together current understanding of their structure, stability, and methods of detection, while also highlighting the main routes through which humans are exposed. Evidence shows that inhalation of endotoxins, particularly in wastewater treatment plants, can impair lung function and trigger strong inflammatory responses, effects that may be intensified when combined with other agents such as glyphosate. Animal studies demonstrate damage to the gastrointestinal tract and blood exposure has been linked to wider systemic conditions, including obesity, insulin resistance, atherosclerosis, and metabolic syndrome. Endotoxins in water and wastewater further illustrate their public health relevance, as conventional treatment processes often fail to completely eliminate them. In biomedical contexts, residual endotoxins not only compromise device sterility but can also interfere with the accuracy of biomarker measurements in blood samples. Taken together, these findings emphasize the resilience of endotoxins under harsh conditions and point to the urgent need for more effective detection, sterilization, and monitoring strategies to protect both human health and the reliability of medical research.